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Latest Posts

The Whistling Nose: How Can It Be Corrected?

Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose.

Why might someone’s nose whistle?

Septal Perforation

The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings.

However, when a hole is present in the septum and it is in just the right size and place, whenever air is breathed in and out of the nose, it will whistle. In this situation, the hole is the “window” of the whistle and the nose itself is the mouthpiece.

Correction of this problem is by Read more »

*This blog post was originally published at Fauquier ENT Blog*

Analyzing Pseudoscience Can Aid In Improving Legitimate Scientific Research

While we frequently on SBM target the worst abuses of science in medicine, it’s important to recognize that doing rigorous science is complex and mainstream scientists often fall short of the ideal. In fact, one of the advantages of exploring pseudoscience in medicine is developing a sensitive detector for errors in logic, method, and analysis. Many of the errors we point out in so-called “alternative” medicine also crop up elsewhere in medicine – although usually to a much less degree.

It is not uncommon, for example, for a paper to fail to adjust for multiple analysis – if you compare many variables you have to take that into consideration when doing the statistical analysis, otherwise the probability of a chance correlation will be increased.

I discussed just last week on NeuroLogica the misapplication of meta-analysis – in this case to the question of whether or not CCSVI correlates with multiple sclerosis. I find this very common in the literature, essentially a failure to Read more »

*This blog post was originally published at Science-Based Medicine*

Research Identifies Aspects Of Spinning That Cause Dizziness

In one of the stranger research projects I’ve encountered in awhile, French scientists reported on why in the sport of discus throwing, athletes tend to feel more dizzy than those who hammer throw.

Whether discus or hammer throwing, both require spinning on part of the athlete before letting the discus/hammer go for long distances.

59% report dizziness with discus throwing, but none with hammer throwing. Why?

This occurred even among athletes who did both sports eliminating individual susceptibilities to dizziness.

Based on slow-motion video analysis, it was conjectured that Read more »

*This blog post was originally published at Fauquier ENT Blog*

Fatigue: A Symptom With Many Possible Causes


Feeling tired? If so, it’s not surprising. Fatigue is one of the most common problems people report to their doctors. The Health and Retirement Study of more than 17 million older people ages 51 and up reported recently that 31% said they feel fatigued.

Fatigue is a symptom, not a disease. Different people experience it in different ways. The tiredness you feel at the end of a long day or after a time zone change might feel similar to that resulting from an illness. But fatigue from stress or lack of sleep usually subsides after a good night’s rest, while disease-related lethargy is more persistent and may be debilitating even after restful sleep.

Finding the cause. How do you know if your low-energy is caused by an underlying illness or is the result of stress, poor diet, or lack of sleep? For example, could you have chronic fatigue syndrome? That is an unusual illness and an uncommon cause of persistent fatigue, says Anthony Komaroff, M.D., professor of medicine at Harvard, world-renowned expert on chronic fatigue syndrome, and medical editor of a new Harvard Special Health Report, Boosting Your Energy. About 4 to 8 of every 1,000 adults in the United States suffer from chronic fatigue syndrome, which is about twice as common in women as in men. The causes of chronic fatigue syndrome are still unknown, and there is no accurate diagnostic test. However, scientists have found abnormalities in the brain and peripheral nervous system, in the immune system, and in energy metabolism in people with this syndrome. Read more »

*This blog post was originally published at Harvard Health Blog*

Is Chronic Fatigue Syndrome Caused By Retroviruses?

When I first heard that a retrovirus had been identified as a possible cause of chronic fatigue syndrome, I withheld judgment and awaited further developments. When I heard that two subsequent studies had failed to replicate the findings of the first, I assumed that the first had been a false alarm and would be disregarded. Not so.

It’s a classic case of wishful thinking outweighing good judgment. One unconfirmed report of an association between the XMRV virus and chronic fatigue syndrome (CFS) resulted in a rush to test for the virus, speculation about possible implications, and even suggestions for treatment. And the subsequent negative studies did little or nothing to reverse the trend. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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